When Selecting An ECG, One Size Does Not Fit All

Primary care and cardiology offices are at the front lines of patient care. As technology evolves and care shifts to lower-cost settings, many enterprise IT departments opt to standardize devices and equipment across inpatient and outpatient settings. While medical device standardization has many benefits, IT departments should keep sight of key workflow differences for outpatient settings when considering any new standardization program.

Acquiring, interpreting and storing ECGs represents a common scenario where a hospital device is not always appropriate for the clinic. Considering a resting ECG is one of the most common tests in a physician’s office—touching many caregivers— streamlining the clinical workflow and connectivity of your ECGs will have providers singing your praises. The following are key considerations to help you keep your clinics running smoothly without sacrificing quality of care.

1. Weigh Features With Efficiency.

ECGs are essential tests used differently across care settings. An interventional cardiologist in a hospital likely requires a different data set than a primary care physician in an office. To support the right workflow (and help minimize support calls), it’s critical to understand the use case before deciding on equipment.

“Standardization tends to work best when we standardize based on the clinical use case,” said Lari Rutherford, senior manager of connectivity at Hillrom. “When ECGs designed for hospitals are pushed into clinics, we often see clinicians struggling to use these more complex devices. A few simple questions can help avoid this.”

Key questions

Who will administer ECGs?

Who will interpret the results?

What is the next step if an abnormality is found? (Another test in the same setting, or a specialist referral?)

“Once the workflow is clear, IT can often achieve the efficiency they’re looking for by selecting specialized devices from the same provider. Similarities in user interfaces, connectivity solutions and purchasing processes can simplify life for IT without complicating it for clinicians—and help reduce costs in the process.”

2. Consider IT Support Available.

While hospitals often have full IT departments on site, this may not be the case in a clinic. These users may call a central helpdesk for support, or even rely on one “tech-savvy” staff member to troubleshoot issues. Therefore, simple issues like an ECG device losing its connection to the wireless network may result in a much higher workload in a clinic than in a hospital.

“This is one reason many clinics opt for a PC-based ECG solution,” said Rutherford. “They’re already using laptops throughout the practice to run the EMR and other software systems, so a support system for those laptops is already in place. Running ECG software on a laptop, rather than training users on an entirely new device, can help minimize training and keep tech support as simple as possible.”

Key questions

What is the support process for ECG solutions?

What amount of training is acceptable for new software and devices?

Are your clinical users already comfortable with laptops?

Standardization tends to work best when we standardize based on the clinical use case. When ECGs designed for hospitals are pushed into clinics, we often see clinicians struggling to use these more complex devices. A few simple questions can help avoid this.”

— Lari Rutherford Senior Manager of Connectivity, Hillrom

3. Be Clear On Where The Data Needs To Go.

The ECG devices you purchase for hospital settings may integrate not just with the EMR, but also the ECG management or PACS system. Before you make this a requirement for devices in your clinics, ask: is it necessary?

“Again, it comes down to understanding the clinical use case,” said Rutherford. “If your clinics frequently share ECG results with hospital practitioners, this level of integration may make sense. But if interpretation typically happens within the office, integration with the EMR may suffice.”

Key questions

Does the clinic frequently share ECG results with hospital practitioners? Or, does interpretation typically happen within the office?

Does the ECG integrate with the most common EMRs used in clinics (Epic, eClinicalWorks, Allscripts, etc.)?

If your clinics frequently share ECG results with hospital practitioners, this level of integration may make sense. But if interpretation typically happens within the office, integration with the EMR may suffice.”

— Lari Rutherford

“Make no mistake—you should expect your ECG provider to help you get the data your teams need where they need it,” said Rutherford. “But asking a few questions may help you narrow your scope and avoid unnecessary complexity and IT support.”

Conclusion

Taking the time to answer a few key questions and collaborate with clinicians will help empower them to provide the best care possible with ECG solutions based on their unique care settings.

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